The health and wellness bubble of privilege

I cannot say how relieved I am that winter is finally over. This one was particularly shit, and saw me get the flu twice, a chest infection, and then, a couple of weeks ago, end up in hospital with pneumonia. The kids didn’t come through unscathed either, with a resurgence of asthma and chest infections. As I’ve spent most of the last fortnight lying in bed recovering, I’ve considered throwing the towel in on this blog, and Instagram, largely because for me, feeling unwell = feeling down = low motivation = what’s the point?

But then an online post which suggested that people who complain that healthy eating is expensive just have their priorities wrong got me fired up again and reminded me why I started this in the first place: because I love food, and I also have things to say about food (and other stuff). I must be feeling better, because the urge to rant has returned.

This period of illness brought to a head something that has irked me about the health and wellness sector over the last few years, in particular a couple of ‘key messages’ that I see and hear regularly:

That food is medicine and prevents illness

That healthy eating isn’t expensive – it’s just a matter of personal choice and responsibility; and people just need to get their priorities in order!

Message 1: Food is medicine and prevents illness

Look, there’s truth to this, undoubtedly. I’ve written before about how changing the way we eat improved my physical and mental health, my children’s and husband’s health, even the health of my parents (both of whom have chronic health issues) and some of my friends. I have more energy, and I hope to be able to avoid some of the chronic health issues from my family history, in my later years. I also hope my kids will continue to develop healthy eating habits.

But while food can build better health and help to prevent illness, it doesn’t provide total immunity. I take issue with the “pay now (for organic food) or pay later (in medical bills)” message that I regularly hear, partly because it blindly ignores privilege, which I’ll discuss below, but also because it’s not true. I eat healthier than anyone in my household, but my husband has always had a stronger immune system (including in the ‘old days’ when he preferred Arnott’s biscuits over rolled oats). Both of my children have asthma. I don’t believe I could have done anything else, diet-wise or otherwise actually, to avoid getting the flu and pneumonia this year. All that messages like these do, is shame unwell people into thinking it’s somehow their own fault.

This one has sat uncomfortably with me for years. I generally have quite left-wing views, and I strongly believe that society and the government has a key role to play in reducing inequality and supporting people, particularly those who are more disadvantaged or vulnerable. The health/wellness sector seems to operate on a much more liberal premise, that it’s just about individuals needing to ‘get their priorities straight’, ‘get educated’ and simply make the choice to eat healthy food (or exercise, both are true); rather than also considering how social and structural barriers play a part in this.

Again, there’s some truth to this, and for some people more than others. But the ‘personal choice’ doesn’t sit in isolation away from the complicated lives that people live. People are complicated, are part of complicated families, in complicated communities, have complicated family histories and intergenerational baggage, all of which contribute to various enablers and barriers in their lifestyles.

I’m really fortunate and privileged to have been able to make diet changes over the last few years. Three years ago, I wrote that healthy eating IS expensive, and in order for it to be most affordable, requires a certain amount of privilege to begin with: a) financial capital, to be able to buy in bulk at reduced rates; b) time, to prepare and cook food from scratch; and c) space and facilities, such as a deep freezer, to store all those cheaper homemade stocks, bulk-buy meats, cooked beans and extra dinners. For example, I buy rolled oats in 15kg batches from Honest to Goodness. We go through HEAPS of oats (looking at you, cyclist husband), and I’ve found this is one of the cheapest ways to buy it. But it does mean forking out $60 to begin with, just for rolled oats, and having bags and bags of the stuff stacked up in my kitchen cupboards. This is do-able for me, but financial capital and space is not a privilege that everyone has.

Fresh produce can also be expensive, even when buying seasonally, especially when we are encouraged to eat a diverse range of fruits and vegetables, and seven serves a day. I’m aware it’s difficult to buy fresh produce in some regional areas of Australia, where it’s either rare to come by and/or extremely pricey. We spend between $70 and $100 a week on fruit and vegetables for a family of four (before meat, dairy, pantry items and other household products). When money’s tight for us and we need to rein in our grocery bill, we inevitably lean towards meals that are more reliant on pasta, rice, bread and noodles to fill tummies, over more nutrient-dense dinners. “Just grow your own!” I hear people saying. Come on… That’s not that easy either, unless you’ve got an established garden already. Growing your own produce also requires capital, time and space to set up (and then crossing your fingers and hoping the goods actually grow).

But these are only a few of the enablers and barriers. There are other enablers that help us make the choice to eat well. Such as having parents who love good food and teach their children how to grow, prepare and cook food, socioeconomic status, school education, mental health and other health issues, social values, social circles, and even the physical environments we live in.

Public health is experienced on a social gradient. That is, people who are more disadvantaged or vulnerable experience worse health, and those who are more affluent and advantaged experience better health, at a population level, both across countries and within countries. This isn’t a coincidence: it is shaped by social, economic and structural inequities. The World Health Organization describes the ‘social determinants of health’ as the ‘circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness’, like socioeconomic position, gender, ethnicity, social class, income, education, occupation, as well as living and working conditions, biological and psychosocial factors. These in turn are shaped by economics, social policies and politics; and they all influence the opportunities that are available to us and the decisions we make.

Sometimes all of these enablers are in place and it’s still not enough. I wasn’t even aware that my diet wasn’t particularly healthy, until there was a trigger: when my mother was diagnosed with diabetes in 2014. Through my own subsequent research, I started to realise that the information we are fed by the food industry is largely misinformation and manipulation. But even with this realisation, it can be hard to make sense of: there’s so much conflicting advice about fat, sugar, dairy, meat, grains, carbs, oils, and with even prominent nutritionists promoting mainstream chocolate brands, it can be confusing. While people who have already changed the way they eat can be quick to judge others for not making the same changes, it’s easy to see why it’s not as simple as ‘priorities’.

While a lot of this is big picture stuff, I do also wonder at times about how the health and wellness sector may also be exacerbating this divide, and whether we are alienating people with our quinoa, spelt flour and nut milks, smoothie bowls, chia puddings, and fermented veggies. I’m not excluding myself from any of these by the way. Except maybe smoothie bowls, I’ve always just found them cold and sloppy, but each to their own. 🙂

So what can we do? Well, in addition to broad social policy change (too big to go into here and covered elsewhere) I’d really love to see some of the big players in the online health and wellness sector look at the role they could play in helping to increase access to healthy eating. Such as through political advocacy, creating accessible and realistic programs, or even by providing concession discounts. But I also hope that we can all stop being so black and white about blaming individuals for illness and lifestyle, and start acknowledging the bigger picture of privilege.

I’m aware that in posting this I’m going against the grain of common thought… So I’m keen to hear your thoughts too. What do you think?

Erin xx

Post-script: Thank-you for reading to the end – you deserve a prize!

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19 Comments

Gee Erin, I didn’t realise you had got so crook this winter. I’ve seen so many results go out on Fridays with more viral pathogens than any other year I can remember since being in Canberra.
I hope you’re a lot better now.

Thanks Gary! Hasn’t it been an awful season for viruses… It’s pretty shocking. You’ve clearly seen the evidence of it! I am a lot better now, thanks, I feel quite lucky to be honest. And I’m always impressed by the public hospital staff, they do a wonderful job.

Thank you for saying this!! As someone who has worked with homeless and vulnerable communities I’ve always felt uncomfortable with that aspect of health and wellness. Check out http://www.spokeandspade.com.au

Thank-you! Yes it makes me very uncomfortable too, it seems to be very narrowly focused. Are you involved with Spoke and Spade? I had a look at the website and it looks like a really interesting initiative!

Flatmate of a friend is involved 🙂 I would love to be if my health was better (I also have a husband with the immune system of a strong, healthy ox – so I totally get you) and our location more ideal. My church is also involved in an initiative to get healthy meals and set up community gardens for and run by vulnerable communities http://www.manyrooms.org.au I am sure there are many other wonderful initiatives out there that I don’t know about!

Glad to see you’re feeling better Erin! What an articulate and AWSOME blog post!

I too feel it’s about the interaction of opportunity, capability and motivation to change … as you suggest the opportunities available to some are less fortunate and yes it’s about time things changed!

You are so right about this, Erin. As a social worker, I’ve often worked with people with very poor health who don’t know how to eat any better, and don’t realise the impact their diet has on their life, and I wish I could share what I know with them – but it’s not my role, I’m not a nutritionist anyway, and even if they had that knowledge, would they really have the resources or ability to do anything about it?
Plus it’s still hard for me to figure out – I’ve been through Whole 30, I Quit Sugar, and naturopathic detoxes, and read quite a few books on the topic, and still haven’t managed to find that elusive food freedom. How can I think my clients simply don’t have the right priorities?

Thanks Esther, and so true! Warwick Lj posted a link to an article in the comments here too which you might be interested in (and which I suspect you will also already agree with) about food insecurity – it articulated really well what I was getting at.
You would totally get it as a social worker – people have so much complicated stuff going on in their lives, sometimes food doesn’t need to or can’t be an added issue to have to deal with.. And I agree, I still get confused about nutrition! The information is so conflicting, and every health source is ‘certain’ that they are right…

I agree with you so much. I do believe that food can be healing, can help your body battle illnesses (it makes such a difference to my mental health as well as my physical health when I eat well), even help keep them at bay sometimes, but not always. The way food is grown now, even organic food, the nutrients in the ground are so depleted by not having a fallow year the food isn’t getting the vitamins and minerals to give to us like it used to. So you can eat all the best food but still won’t be getting the same nutrients that our grandparents got. So eating healthily isn’t always going to stop you getting sick.

As for the cost, I can’t afford to buy organic and it’s not even about changing stuff I buy. With 3 growing kids that never stop eating I have to give them stuff that fills them. But two of my kids are fussy eaters, they would be happy having a typical uk meat and veg meal every night. But I get bored with that as does hubby and my eldest. But there is so much that they just won’t eat (even if it’s food they like separately just not combined 🙄) that I’m not spending lots on food for it to not be eaten and then thrown away. And yes, I do use leftovers, just not when it’s been mushed around on a plate! And I don’t have a big enough garden to grow veg, I either grow veg or the kids have outdoor space to play. I tried growing things in pots 2 years in a row. The first year was a typical uk summer and it rained the whole time so I lost everything as it was too water logged. The next year we had a unexpected heat wave and everything got burnt to a crisp so I lost it all! So I gave up!

The other thing I do find sometimes in the health community is how judged you can sometimes feel if you are only dabbling and not every meal is nutrient dense, healthy eating. It can be very off putting, like it is its own clique and if you don’t fit in to it you are a lesser mortal (not pointing fingers at you, just ranting!!). It would be great to see some of the bigger personalities get on board with your thoughts, they are great 👍🏼

Don’t be sorry Faye, I LOVE a long waffle! 🙂 I think you’re spot on, I agree with everything you’ve said. I think you’re right about the nutrients in the soil being depleted, I’m sure I read something that said the old ‘apple a day keeps the doctor away’ idea would no longer stand, it would have to be more like 5 apples a day, because the nutrient value isn’t the same.

I hear you on the veggie patch too. It’s so costly. We’re slowing getting one in place, but it’s taking forever, because we have to pace it out against our pay-days (saving up the buy the veggie beds, then saving up again to buy the soil – that’s before we even have any seedlings!). Here in Canberra we have really hot dry summers so we tend to find that veggies burn quickly as well. So this idea that it should be easy for everyone to go out and grow their own food is a little ill-informed.

Also, I don’t like eating my kids leftovers either 🙂 It’s looks so unappealing after they’ve mashed it all up and slobbered all over it! Thanks so much for your thoughtful feedback. 🙂

I couldn’t agree with this more. The whole situation is compounded also because of the family situations a lot of people are on. Veggies will add greatly to a persons micro nutrient status, and by way of “healthy” eating some frozen veg is cheaper than other healthy items like fats and proteins, but the most accessible healthy items aren’t the ones that keep you full and they’re also the ones likely to be least well received by dependants.

I hate the argument of priority because it assumes parents aren’t trying their best for their kids. This just isn’t true, I don’t know a single parent who isn’t doing what they can, where they can. But if you have a situation where you are working every available hour, looking after children and producing a meal only for them to not eat it, I can see it being a demoralising situation pretty quick. It’s a total privilege as a parent to have food waste because you’re trying to get your kids to eat new things.

This is even if families can navigate their way through the mixed messaging and marketing directed to them.

I saw the post that started this rant and was so disappointed. Mostly because this group has done a lot for common sense health messaging. It would help a lot more people if we stopped blaming the vulnerable and actually just said yes this is really hard, how can we help?

Thanks for your thoughtful comment! You’re totally right about the most accessible healthy items being the ones less well received – I find myself hiding them in things like smoothies (which aren’t necessarily cheap to make either, so that’s yet another thing I’m privileged to do).

I also agree with you that parents are doing what they can, where they can – and they also have different skill sets. I love cooking for and feeding the kids, but I’m shithouse at playing outside with them. I like helping them with reading, but useless with maths. Every parent can’t be everything.

I love the concept of offering help instead of judgment. And to do that we need to understand why people may not be eating optimally for their health and remember everyones story is different. Thank you for starting the conversation and inspiring me to do more to make real food more real.

Thanks so much Rani. You know I was thinking of you as I wrote this, because I think you do manage to deliver on healthy food recipes that are also accessible and affordable, and don’t involve lots of complicated ingredients (which is why I go to your website for family dinners so often!).